Provider Demographics
NPI:1801465174
Name:ASHLAND DENTAL SURGICAL SOLUTIONS LLC
Entity type:Organization
Organization Name:ASHLAND DENTAL SURGICAL SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:MUSSETTER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:606-465-4366
Mailing Address - Street 1:PO BOX 941
Mailing Address - Street 2:
Mailing Address - City:FLATWOODS
Mailing Address - State:KY
Mailing Address - Zip Code:41139-0941
Mailing Address - Country:US
Mailing Address - Phone:606-465-4366
Mailing Address - Fax:
Practice Address - Street 1:2135 ARGILLITE RD STE N
Practice Address - Street 2:
Practice Address - City:FLATWOODS
Practice Address - State:KY
Practice Address - Zip Code:41139-1629
Practice Address - Country:US
Practice Address - Phone:606-465-4366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental